Functional brain imaging in pure akinesia with gait freezing: [18F] FDG PET and [18F] FP-CIT PET analyses.
Pure akinesia with gait freezing (PAGF) has characteristic features, including freezing of gait and prominent speech disturbance without rigidity or tremor. The purpose of this study was to investigate changes in brain glucose metabolism and presynaptic dopaminergic function in PAGF. By using [(18)F] fluorodeoxyglucose (FDG) PET, 11 patients with PAGF were compared with 14 patients with probable progressive supranuclear palsy (PSP), 13 patients with Parkinson's disease (PD), and 11 normal controls. [(18)F] N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (FP-CIT) PET was performed in 11 patients with PAGF and with 10 normal controls. The PAGF patients showed decreased glucose metabolism in the midbrain when compared with normal controls. PSP patients showed a similar topographic distribution of glucose hypometabolism with additional areas, including the frontal cortex, when compared with normal controls. The FP-CIT PET findings in patients with PAGF revealed severely decreased uptake bilaterally in the basal ganglia. These findings suggest that both PAGF and PSP may be part of the same pathophysiologic spectrum of disease. However, the reason why PAGF manifests clinically in a different manner needs to be further elucidated.
Park
Hee K
HK
Department of Neurology, Center for Parkinsonism and Other Movement Disorders, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim
Jae S
JS
Im
Ki C
KC
Oh
Seung J
SJ
Kim
Mi J
MJ
Lee
Jae-Hong
JH
Chung
Sun J
SJ
Lee
Myoung C
MC
D000368:Aged; D000369:Aged, 80 and over; D001480:Basal Ganglia Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D002250:Carbon Radioisotopes; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D005947:Glucose / Q000378:metabolism; D006801:Humans; D018476:Hypokinesia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D007457:Iodine Radioisotopes; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000378:metabolism; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000000981:diagnostic imaging*; D014326:Tropanes
D002250:Carbon Radioisotopes; D005462:Fluorine Radioisotopes; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D014326:Tropanes; D019788:Fluorodeoxyglucose F18; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane; D005947:Glucose